A study on the pathogenesis of postmastectomy lymphedema

Area of Science:

• Oncology
• Vascular Surgery
• Radiology

Background:

• Postmastectomy lymphedema is a common complication following breast cancer surgery.
• The exact pathophysiology of lymphedema after mastectomy requires further elucidation.

Purpose of the Study:

• To investigate the etiological factors of postmastectomy lymphedema.
• To correlate imaging findings with the clinical presentation of lymphedema.

Main Methods:

• Venography, lymphangiography, and radioiodinated serum albumin (RISA) absorption tests were performed on patients post-radical mastectomy.
• Axillary lymphangiography findings were analyzed in relation to the degree of upper extremity edema.

Main Results:

• Venous obstruction was identified as a rare cause of postmastectomy lymphedema.
• Lymphangiography demonstrated edema patterns in both edematous and some non-edematous extremities.
• Absence of adequate lymphatic pathways across the axilla (Type 2: collateral, Type 3: blocking) correlated with lymphedema.
• RISA absorption tests showed lower lymphatic flow in patients with edema compared to those without.

Conclusions:

• Inadequate lymphatic pathways across the axilla are a primary cause of postmastectomy lymphedema.
• Lymphangiography and RISA absorption tests are valuable tools for assessing lymphatic function and diagnosing lymphedema.